I-Sovaldi (sofosbuvir) iyi-nucleotide inoveli ye-polymerase inhibitor ekilasini yezidakamizwa esetshenziselwa inhlanganisela yokwelapha i-antiviral yokwelapha i- hepatitis C (HCV) . I-Sovaldi isebenza ngokuvimbela i-enzyme eyenziwa yi-HCV ukuze iphinde ibuyele i-RNA yayo, iphazamise ngempumelelo isiteji sempilo yegciwane.
I-Sovaldi yamukelwa ngo-Disemba 2013 yi-US Food and Drug Administration (FDA) ukuze isebenzise kubantu abadala kweminyaka engu-18 noma ngaphezulu nge-HCV genotype 1, 2, 3 no-4 ukutheleleka, kuhlanganise nalabo abane- hepatocellular carcinoma (uhlobo oluvame kakhulu lomdlavuza wesibindi) kanye nabantu abane- HIV / HCV ukutheleleka kokunye.
I-Sovaldi ivunyelwe ukuthi isetshenziswe ngeziguli ezingaphathwa kabi (iziguli-naïve), kanye nalabo abanengxenye engaphelele noma engekho emthonjeni we-HCV wangaphambili.
Ucwaningo lwezokwelapha luye lwabonisa ukuthi izinga lokuphulukiswa kweziguli ezithola ukwelapha emzimbeni wesisekelo seSovaldi liphakathi kuka-82% no-96%.
Isilinganiso
I-tablet eyodwa ye-400 mg ethathwe nsuku zonke noma ngaphandle kokudla. Amaphilisi e-Sovaldi aphuzi futhi aphethwe ngamafilimu, aphethe "i-GSI" emaceleni kolunye uhlangothi futhi "7977" ngakolunye uhlangothi.
Ukubeka izincomo
I-Sovaldi inqunyelwe ukuthi isetshenziswe ngendlela yokwelashwa ehlangene ne- ribavirin ; ne-interferon ye-pegylated (i-peg-interferon) + i-ribavirin; noma ngeDadlinza (daclatasvir) . I-Sovaldi akumele isetshenziswe njenge-monotherapy.
Izinqubo ezilandelayo zokwelapha zinconywa:
- I-Genotype 1 noma 4: I-Sovaldi + peg-interferon + ribavirin yamaviki angu-12
- I-Genotype 2: I-Sovaldi + ribavirin yamaviki angu-12.
- I-Genotype 3: I-Sovaldi + ribavirin yamaviki angu-24 NOMA u-Sovaldi + Daklinza (daclatasvir) amasonto angu-12
Kulezi ziguli ezine-genotype 1 ezingenakuvunyelwa i-interferon noma i-interferon-engaxhasi, kunconywa ukuba inhlanganisela yeSovaldi + ribavirin ibekwe amasonto angu-24.
Kuphi ukufakelwa kwesibindi okulindeleke ngesineke, lezi zindlela zokwelashwa ezibalwe ngenhla kufanele zibekwe amasonto ama-48 noma kuze kube khona ukufakelwa, noma yikuphi okuza kuqala.
Imiphumela Ejwayelekile Ejwayelekile
Imiphumela emibi kakhulu ehlobene nokusetshenziswa kwe-Sovaldi + ribavirin (okungukuthi, eyenzeka ngo-20% noma ngaphansi kweziguli) yilezi:
- Ukukhathala
- Izinwele
- I-nausea
Imiphumela emibi kakhulu evezwe ezigulini ezisetshenziswa i-Sovaldi + ribavirin + peg-interferon yilezi:
- Ukukhathala
- Izinwele
- I-nausea
- Ukungalali
- I-anemia
Ngaphandle kwe-anemia ne-neutropenia, iningi lemiphumela emibi ehlotshaniswa nokusetshenziswa kwe-Sovaldi kuthathwa njengobumnene noma isikhathi esincane (iBanga 1).
Emcwaningweni wezokwelapha, u-1% noma ngaphansi kweziguli eziseSovaldi + ribavirin zaqeda ukwelashwa ngaphambi kwesikhathi ngenxa yemiphumela emibi. Lesi sigameko senyuke ku-11% iziguli eSovaldi + ribavirin + peg-interferon.
Ukusebenzisana kwezidakamizwa
Okulandelayo kufanele futhi kugwenywe uma usebenzisa i-Sovaldi:
- Imithi elwa namagciwane e-Rifampin: I-Mycobutin, i-Rifater, i- Rifamate, i-Rimactane, i- Rifadin, i-Priftin
- Anticonvulsants: Tegretol, Dilantin, Trileptal, phenobarbital
- Wort St. John's Wort
Kulabo abanegciwane lesandulela ngculaza , iSovaldi akufanele ilawulwe ngokucophelela nge-Aptivus (tipranavir) noma i-Norvir (ritonavir) njengoba lezi zidambisigciwane ze-protease ezinama- antiretrovirals zinganciphisa ukuhlushwa kwe-serval ye-Sovaldi.
Ukungafani
I-Sovaldi iphikisana nokusetshenziswa ngesikhathi sokukhulelwa noma emadodeni abathandayo abathintekayo njengoba izifundo zezilwane ziye zaphakamisa ingozi engaba khona yokukhubazeka kokuzalwa noma ukufa komntwana.
Kunconywa ukuthi bonke abesifazane abaneminyaka yobudala ababelethwe yingane kumele bahlolwe njalo ngenyanga ngokukhulelwa ngesikhathi sokulashwa. Kunconywa ukuthi isiguli kanye nomlingani wakhe wesilisa banikezwe okungenani izindlela ezimbili ezingekho ze-hormonal zokuvimbela ukukhulelwa nokuthi zisetshenziselwa ukwelashwa kanye nezinyanga eziyisithupha emva kwalokho.
Umthombo:
Manns, M. and Cornberg, M. "Sofosbuvir: Isipikili sokugcina ebhokisini le-hepatitis C?" I-Lancet. Mashi 15, 2013; 13 (5): 378-379.